Parasitic diseases (3rd edn)

Parasitic diseases (3rd edn)

Book Reviews 1132 assembling a number of papers which direct the interested student and the uninitiated researcher into the enormous volume of liter...

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Book Reviews


assembling a number of papers which direct the interested student and the uninitiated researcher into the enormous volume of literature on the subject. The contributions are all of a high standard and provide a state of the art analysis of the modes of resistance encountered in parasites. The collection commences with a kinetic analysis of the fate of a¶sitic drugs in livestock (D. R. Hennessy) which points up the need for efficient application of the compounds currently in use, and finishes with an elegant account of the biochemistry of benzimidazole resistance (E. Lacey and J. H. Gill). In between, in an excellent review of resistance in malaria, W. H. Wernsdorfer observes pessimistically that we shall soon reach the stage where there are no effective drugs for dealing with resistant malaria and that we shall have to live with resistance. He concludes with a plaintive “But how can this be done?’ This pessimism is echoed in an account of what is known and, more important, what is not known about the mechanism of resistance to antimalarial drugs (S. J. Foote and A. F. Cowman). Rather more optimistic assessments for other pathogenic Protozoa are offered by S. M. Townson et al. and P. Upcroft. Although parasitic helminths are dealt with in general in three of the papers in this collection, only the schistosomes are singled out for detailed treatment (P. J. Brindley). Of all human helminth infections, resistance is only apparent in this group of organisms. This is, of course, in marked contrast to the situation for animal parasites, where repeated chemotherapeutic treatments rapidly produce resistance. The problem when resistance in human helminths arises is that there are so few safe anthelmintic agents available and few, if any, new ones on the horizon. The full titles of the papers in this important


collection are as follows: The disposition of antiparasitic drugs in relation to the development of resistance in parasites of livestock, D. R. Hennessy, pp. 125-142; Epidemiology of drug resistance in malaria, W. Wernsdorfer, pp. 143-156, The mode of action and the mechanism of resistance to antimalarial drugs, S. Foote &t A. Cowman, pp, 157-172; Resistance to nitroheterocyclic drugs, S. M. Townson, P. F. L. Boreham, P. Upcroft % J. A. Upcroft, pp. 173-194; Multiple drug resistance in the pathogenic protozoa, P. Upcroft, pp. 195-212; Drug resistance to schistosomicides and other anthelmintics of medical significance, P. Brindley, pp. 213-232; The development of anthelmintic resistance in ruminant livestock, P. J. Wailer, pp.233-244; Biochemistry of benzimidazole resistance, E. Lacey & J. H. Gill, pp. 245-262. Perhaps a minor, carping criticism of this issue is that only two of the authors are not Australian and a different perspective might have been achieved with a wider cast of the net. As well, the cost of purchase of this single issue is rather high (this sitrgle issue costs DFL220.50), though the papers are accessible by other means. But these are minor criticisms and if this special issue is read in conjunct&on with an earlier compendium (Resistance of Parasites to Antiparasite Drugs, eds J. C. Boray, P. J. Martin and R. T. Roush, MSD AGVET, Division of Merck & Co. Inc., Rahway, New Jersey, pp.219, 1990) the reader will have almost everything he or she ever wanted to know about resistance. C. BRYANT, Division of Biochemistry and Molecular Biology, Australian National llniversity, Canberra, ACT 2600, Australia.


(3rd eda)

D. D. Despommier, R. W. Gwadz and P. J. Hotez. Springer, New York, 1995, 333 pp. US$SO. ISBN O-387-94223-8. For a fairly conventional text to go into its third edition clearly indicates that it has an established niche, that the authors believe sufficient new information has justified a major revision, and that it has an assured market. In the process, one of the previous authors has been replaced, and many chapters have been revised, with fresh references

and the addition of “new” organisms. The audience is identiiied as medical students and practitioners, and a glowing Foreward promises new understanding based on cell and molecular biology, immunology, genetics, and basic biology that are presented succinctly and clearly, and structured under headings in a well-organized fashion.



The book comprises 40 chapters, each based on a single parasite species or group of organisms closely related, either taxonomically or by some other characteristic, such as being of “minor medical importance”. Section I comprises 74 pages on nematodes, II has 32 pages about cestodes, III includes 32 pages dealing with trematodes, IV (the largest) devotes 96 pages to protozoa and V has 51 pages on arthropods. Four appendices relate to chemotherapy (a straight reprint from The Medical Letter of 10 December 1993) and laboratory diagnosisof parasitic infections. Does this book bear up to its promises?It is consistently set out, and copiously illustrated with large life-cycle diagrams and monochrome photographs of the parasites(plus the obligatory colour plates of malaria stages in blood films), their intermediatehostsand pathological specimensfrom infections. Beyond that, regrettably, I was disappointed. There are no adequateintroductory sections explaining how the parasite speciesfit together and within the greaterschemeof life generally.It doesnot progresslogically, e.g. by starting with the smallest, the protozoa. Even within groups, such as the protozoa, the sequenceof speciesis idiosyncratic. Minor typographical errors are commonand, worse, so are errors of fact. How can one forgive the consistentmis-spellingof sucha great nameasthat of Arthur Looss (“Loos”)? Or the implication that Fasciola hepatica is larger than Fasciolopsis buskl? The useof languageis often carelessand ambiguous, with somesectionsrather disjointed, ambiguousor contradictory (e.g. on babesiosis).The terminology for stagesin the important life-cycle of Toxoplasma gondii is unconventional and confusing. These are not isolatedexamples.Epidemiology, and details of life-cycles and biology, are given very scanty treatment. Frequently, statementsof new scientific fact, and pathogenicmechanisms,are expoundeddogmatically without any circumspection.The Historical Information in most chapters comprised what seemedto be eclecticstringsof namesand datesthat would hardly excite even the exceptional student. Many of the illustrations, particularly the photomicrographs, are of poor quality and do little to reinforce the text. Is it really necessaryto include


serialviews,taken at different focal planes,simply to demonstratethat the cysts of Entamoeba histolytica and Escherichia coli do, indeed,have severalnuclei? Of what value is the comprehensivecatalogue of microfilarial photographs,virtually duplicatedin the main body and in the Diagnostic Atlas (Appendix IV), especiallyto the medicalstudent?Other photographsare alsoreplicatedin the technicalappendices, although laboratory personnelwould hardly usethis book in preferenceto specific technical laboratory manualsand atlases.Scalebars, or actual dimensions of organisms,would be more helpful than indicating the magnificationof eachphotograph. While the lifecycle diagramsare attractively executed,they occupy entire pages; it seemsextravagant to dedicate a separatepagefor eachof the 3 major schistosomes of humans,2 pagesto Taenia solium and T. saginata and a whole pageto Balantidium coli. Trying to view this book from the perspectiveof a medicalstudent.I fearedit could be rather confusing, unlessstrongly supplementedby a lecture courseand laboratory classes.It would be kinder to regard it as a book for “mature audiences”,written for people who already know the subject,and seekto brush up on desultory snippetsof interestinginformation. One could play “spot the mistakes”,and scorein almost every section. Such a reader would also be more likely to appreciateone of the book’s strengths,its substantial lists of recent and pertinent references (eventhough theseare heavily biassedtowardsNorth American publications). A captive audienceof U.S. medicalstudentsmay find this book in its present format to be a useful adjunct to a particular course,but for my students,I could only recommendone of severalcheaperand more thoughtfully compiled alternatives that are already available. However, with careful attention to proof-reading, illustrations and re-definition of their goals,the authors could readily improve this into a very desirableand useful volume. PAUL PROCIV, Department of Parasitology, The University of Queensland, Queensland4072, Australia.